Occupational Asthma Reference

Ilgaz A, Moore VC, Robertson AS, Walters GI, Burge PS, Occupational asthma; the limited role of air-fed respiratory protective equipment, Occup Med, 2019;69:329-335,https://doi.org/10.1093/occmed/kqz074

Keywords: OA, Oasys, UK, respiratory protective equipment, RPE, control, metalworking fluid

Known Authors

Sherwood Burge, Oasys Sherwood Burge

Vicky Moore, Oasys Vicky Moore

Alastair Robertson, Selly Oak Hospital Alastair Robertson

Gareth Walters, Heartlands Gareth Walters

Asilan Ilgaz, Ankara, Turkey Asilan Ilgaz

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Abstract

Background
The effect of depression on both employment and productivity in type 2 diabetes (T2D) is poorly understood.

Aims
We tested whether depressive symptoms at diagnosis of T2D are associated with change in employment status and productivity over 2-year follow-up.

Methods
In a prospective analysis of working-age (18–63 years) people with newly diagnosed T2D recruited from primary care, we tested the association between depressive symptoms at diagnosis of T2D (baseline) and employment rates over 2 years. Using the Patient Health Questionnaire-9, depressive symptoms were measured categorically (depression caseness score =10) and continuously. In those employed, we measured changes in presenteeism and absenteeism using the World Health Organization (WHO) Health and Work Performance Questionnaire in univariate and multivariate models, respectively, including and excluding part-time workers.

Results
Of 1202 people aged 18–63 at baseline, 982 (82%) provided employment information; the mean age was 50.3 (SD 8.1) years, 44% were female, 59% of non-white ethnicity and 16% had depression. After adjustment for age, sex, ethnicity, socio-economic status, diabetes control and depression treatment, depression caseness was associated with worsening unemployment over 2 years only in full-time workers (odds ratio 0.43 (95% CI 0.20, 0.96), P < 0.05). In those employed full-time or part-time, total depressive symptoms were associated with worsening presenteeism over 2 years after full adjustment (ß = -2.63 (95% CI -4.81, -0.45), P < 0.05), despite no association with worsening absenteeism.

Conclusions
In newly diagnosed T2D, depressive symptoms demonstrate an association with worsening employment rate and decline in work productivity over 2-year follow-up.

Plain text: Background The effect of depression on both employment and productivity in type 2 diabetes (T2D) is poorly understood. Aims We tested whether depressive symptoms at diagnosis of T2D are associated with change in employment status and productivity over 2-year follow-up. Methods In a prospective analysis of working-age (18-63 years) people with newly diagnosed T2D recruited from primary care, we tested the association between depressive symptoms at diagnosis of T2D (baseline) and employment rates over 2 years. Using the Patient Health Questionnaire-9, depressive symptoms were measured categorically (depression caseness score >=10) and continuously. In those employed, we measured changes in presenteeism and absenteeism using the World Health Organization (WHO) Health and Work Performance Questionnaire in univariate and multivariate models, respectively, including and excluding part-time workers. Results Of 1202 people aged 18-63 at baseline, 982 (82%) provided employment information; the mean age was 50.3 (SD 8.1) years, 44% were female, 59% of non-white ethnicity and 16% had depression. After adjustment for age, sex, ethnicity, socio-economic status, diabetes control and depression treatment, depression caseness was associated with worsening unemployment over 2 years only in full-time workers (odds ratio 0.43 (95% CI 0.20, 0.96), P < 0.05). In those employed full-time or part-time, total depressive symptoms were associated with worsening presenteeism over 2 years after full adjustment (b = -2.63 (95% CI -4.81, -0.45), P < 0.05), despite no association with worsening absenteeism. Conclusions In newly diagnosed T2D, depressive symptoms demonstrate an association with worsening employment rate and decline in work productivity over 2-year follow-up.

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Associated Questions

Registered users of this website have associated this reference with the following questions. This association is not a part of the BOHRF occupational asthma guidelines.

What evidence is there for the benefit of the enhanced use of respiratory protective equipment?
burgeps This study clearly shows the limited role of high-level RPE in the control of occupational asthma from metalworking fluids in those already sensitised. The ABC plot from the Oasys system was used to compare pre and post RPE with airfed helmets donned and removed outside the workplace. Source control is more likely to work.

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